Case Study – Teenage Sports Knee Injury

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Patient is a 17 year old very athletic/active male who plays multiple sports ie. football, winter track, basketball and tennis as well as being a regular healthy, active teenager. The patient sustained a grade 1 MCL strain and was referred directly from the pediatric orthopedic for frequent visits 16 days post injury. In addition to rehabbing his injury for a return to normal ADL’s, he was hoping to play in his last high school football game. He has never received PT prior to this injury.
On evaluation, patient presented with relatively good ROM at his knee passively, however all MMT resulted in increased pain, with decreased ability of the patient’s lower extremity to react timely and with maximum strength that a 17 year old active male should have for his LOA. He had decreased VMO strength and proprioception as well as decreased hip strength contributing to knee alignment. He demonstrated poor technique with exercises and decreased knowledge of basic injury management. He was wearing a knee brace at all times.
Physical therapy was initiated for stretching, myofascial release techniques, soft tissue mobilization, joint mobilizations, proprioception activities, strengthening, and patient education especially with regards to form for exercises, importance of acute injury management and injury management to prevent re-injury which may lead to more significant damage and/or surgery. No formal protocol was provided by MD. Patient was seen for a total of 5 visits and was very compliant with his HEP. In addition, we had close communication with the athletic trainer to ensure support and taping and good carryover to daily activities for the individual.
With soft tissue techniques and manual techniques as well as quickly addressing edema, pain, decreased ROM and strength that were impairing normal gait and ADL’s, he quickly progressed to no brace except for high level activities. The biggest focus was on proprioceptive input for the knee joint and muscles to ensure a full return to PLOF to prevent recurrence of injury. At discharge after only 5 visits, the orthopedic cleared him for return to sports. With continuation of his FOCUSED HEP and new knowledge regarding his individual strengths & weakness as well as injury management, there is a decreased risk of further knee injury.